Opportunistic fungal infections in patients with neoplastic disease.

Opportunistic infections with yeast and molds are increasingly common in patients with neoplastic diseases. Candida species, Aspergillus species, Phycomyces, and Cryptococcus neoformans remain most common, but other organisms are being encountered as pathogens. With the exception of Cryptococcus, most opportunistic fungal infections are difficult to diagnose. New diagnostic tests for these diseases are being evaluated. Amphotericin B remains the antifungal agent of choice. In certain patients, the addition of 5-fluorocytosine may improve the outcome. Experience with cryptococcosis in severely immunocompromised cancer patients at Memorial Sloan-Kettering Cancer Center suggests that those who are treated with amphotericin B intravenously and intraventricularly via an Ommaya reservoir along with 5-fluorocytosine do better than those treated with amphotericin B alone.